A student has her temperature taken to monitor symptoms of flu. Most cases of swine flu in Canada have been mild, but there is a subset of patients who are getting very sick.
Photograph by: Yasser Al-Zayyat, AFP/Getty Images

WINNIPEG â An intensive care doctor speaking Wednesday at a conference on the H1N1 pandemic said the virus is the "most frightening" thing he has seen in his career â and other experts here warned that hospitals are not yet ready for a surge of severely sick patients.

In an interview just prior to his address, Dr. Anand Kumar said he wanted to give the audience "the flavour" of what hospitals can expect to see when the second wave of the pandemic is expected to come this fall and winter.

"I think it's an absolutely massive onslaught of incredibly sick young people that I had never imagined I would see in my life," Kumar said of his experience treating patients in Winnipeg's intensive care units. "It's startling, and more than a little frightening, especially when you don't know what the ceiling of this is going to be."

The two-day conference, which has drawn together about 150 health-care professionals and experts from across the country and around the world, is focused on how to manage severe cases of the swine flu and prevent them from deteriorating. Also on the agenda are discussions about Canada's vaccine strategy â under attack this week from the Canadian Medical Association Journal â the use of antivirals, medical ethics and clinical care guidelines. The sessions are closed to media.

Most cases of swine flu in Canada have been mild, but there is a subset of patients who are getting very sick. At least 72 deaths have been linked to H1N1 and more than 1,366 people have been hospitalized. Of those patients, more than 240 have spent time in intensive care units.

The virus's behaviour differs from that of other flu bugs in that it attacks younger people at disproportionately higher rates, rather than the very old and very young who are normally more susceptible to flu. Researchers still don't know why it is hitting some people so hard, particularly when they have no underlying health conditions or risk factors such as pregnancy.

Kumar said that, of the patients who were hospitalized in Winnipeg, two-thirds were young and healthy people who were "essentially struck down in the prime of their life" and that hospitals were filled with "rows and rows" of young patients in their 20s, 30s and 40s. He called it a "bizarre experience."

"I've been doing this for 28 years and it's probably the most frightening thing I've ever seen professionally," he said.

Some of the people who got "spectacularly ill" could barely get any oxygen from a ventilator into their lungs because they were so filled with fluid, said Kumar, and some patients had lungs so damaged that a ventilator didn't work.

Despite the rather ominous description offered by Kumar, he said young and healthy people shouldn't be scared and that the vast majority of people who contract the virus recover well.

Hospitals, however, know they need to prepare for an onslaught of critically ill patients in the event the pandemic worsens.

Dr. Robert Fowler, a critical care specialist and associate professor at the University of Toronto, said the second wave is not going to hit every city at the same time and jurisdictions should be able to share resources, such as ventilators and personnel. Those plans are not yet ready to be activated, said Fowler, and hospitals in general are not ready for high numbers of swine flu patients to walk through their doors.

"Are we ready? I think lots of work has been done, but we're not ready," said Fowler. "There's still lots more work to be done over the next weeks to months."

Some hospitals are already pushed to their limits when caring for critically ill patients, and the possibility of being pushed beyond those limits is causing a lot of worry, he said.

Dr. Gerald Evans, an expert from Queen's University who will address the conference Thursday, echoed those concerns.

"Canadian health care is sort of premised on the idea that we run at near 100 per cent capacity, so the lack of a surge capacity, the ability to take a big huge surge of people, is a significant problem," he said.

More hospital beds are needed, more advanced ventilators are required, as well as the people trained to operate them, and strategies are needed to prevent serious cases from turning deadly, the experts said. Those strategies will be discussed in detail during the second day of the conference.

I dont know what the media is trying to do. H1N1 is not that scary. This doctor must have been paid to say that its the most frightening thing she's ever seen. That or she just started her medical career.

More people die every day from the flu than from the total number of people that have died from h1n1.

The World Health Organization (WHO) has acknowledged what regular readers of Health Spectator already knew: that the ânewâ H1N1 swine flu has a tendency to devastate the lungs in at least a significant portion of the people it infects. We reported on July 23 that University of Wisconsin virologist Yoshihiro Kawaoka had found H1N1 produces more severe lung lesions than seasonal flu in non-swine mammals.

The WHO currently puts the fraction of patients who need intensive care as a result of direct lung infection as high as 15%. Should the same prove true in the U.S. as the new wave of flu strikes this fall, it could put a strain on medical facilities.

The other distinctive trait of the new flu is its tendency to strike harder against the young. Whereas the elderly are normally most affected by seasonal flu, WHO is reporting that H1N1 infection is 20 times more common in the 5-to-24 age bracket than in those over 65. Some believe that the elderly have some natural resistance to the new flu from having been exposed to similar strains in the past. Others attribute the vulnerability of the otherwise healthy to the disease causing a so-called âcytokine storm,â which is an extreme reaction on the part of the immune system that causes more harm than the virus itself. Those with stronger, healthier immune systems are more likely to be severely affected, the reasoning goes.

Although WHO is also reporting a greater susceptibility to new flu among minorities and indigenous populations in South America, it is not clear whether a similar prevalence will result here in the United States. In other countries, the disparity may be the result of differing social conditions and medical care.

I dont know what the media is trying to do. H1N1 is not that scary. This doctor must have been paid to say that its the most frightening thing she's ever seen. That or she just started her medical career.

More people die every day from the flu than from the total number of people that have died from h1n1.

I think there is something seriously fishy going on with this media scare tactic and I would never take any h1n1 vaccination with all this fishyness

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According to the web site you posted (which list deaths from influenza and pneumonia combined), 257 people died from the flu in 2001, and 0.1 people per 100,000 population die in the US 2001. (That's about 330 people or so) I don't know what the real number is, because I keep coming across conflicting reports.

Are all pneumonia cases lumped together or do officials separate non-influenza linked fatalities? Is there even an accurate way to differentiate the two? Also, since the vast majority of deaths are apparently from pneumonia, perhaps it's time to focus on a pneumonia vaccine instead of an influenza vaccine.

I would like to add, the garden variety flu tends to kill those already weak from an illness or the very old or the very young, unlike the Spanish Flu or, potentially, a variation of the H1N1 virus. There's a slight difference in your 80-year old grandmother succumbing to the flu and your 38-year old cousin unexpectedly passing away in the hospital due to the H1N1 virus.

[B. Also on the agenda are discussions about Canada's vaccine strategy â under attack this week from the Canadian Medical Association Journal â the use of antivirals, medical ethics and clinical care guidelines. The sessions are closed to media.

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All is written in black : THE SESSIONS ARE CLOSED TO MEDIA... what the hell is going on ? We, the market participant have the most comprehensive, totally informative view on the world ( weather, stats, spacial pictures, psycho analysis, computer running 24h 7/7... ).

First Everyone is afraid of us ! they know we know what they don't...

Second, Medicine is a scam ! a true one. How the hell could have man trust that by harming him he could get better. True medecine is the soul...

Third. All of this is made to vaccine us... Why should you be vaccined ? To not kill the youngs . So if you don't vaccine you are a bad American, because you are jeopardizing the future of America. And to be sure that you have take well your vaccine, it will be added and RFID CHIPS inside the vaccine...

It's done... tooooo late.... your are a human with a serial number...

Conclusion : if you wanna win a lota of money go to the Rfid tech. How to fake them, how to load/unload them, what codes etc...

Since that spread between reported cases and deaths is widening is quite possible that tons of people are being reported to have swine flu but just have any number of other diseases and are being misdiagnosed. Modern conventional medicine is not very efficient except for surgeries